Alexander Lopera Email & Phone Number

Medical Bill Gurus was founded as a passionate project for me. I have spent the last nineteen years in the financial realm of the healthcare industry (billing, coding, collections, fee-negotiations, retrospective audits). Over those years, I have had countless conversations with acquaintances, friends, and family where they would ask me for advice on outstanding medical bills, collections letters from doctors, and explanation of benefits from insurance companies. It has become very obvious to me that the system is broken, complex, and extremely hard to navigate. Insurance carriers are for-profit companies and make no money by approving every claim. Doctors and hospitals are short staffed and systematically have billing errors. For years I have discussed establishing a business with its sole purpose is to offer value and solutions to its customers. Medical Bill Gurus was established to address this desperate need in the consumer market. By staffing our office with compassionate and knowledgeable people, we will fill this void in the market and help consumers navigate these complex issues.

AMHA offers three comprehensive services that each addresses a specific revenue cycle need with unique solutions.MEDICAL BILLING & COLLECTIONS – Inadequate billing systems and procedures are often the culprit of staff inefficiencies, patient frustrations, and missed revenue opportunities. Because of these setbacks many offices often look to relinquish the billing responsibilities to an outside source like AMHA. Our comprehensive medical billing services include claim submission, tracking, follow-up, payment posting, patient billing, as well as quarterly evaluations. Our niche includes understanding "internal payor logic" within the insurance industry and applying a strategy known as Insurance Compliance Management (ICM). By this model we help payors comply with federal and state guidelines while adjusting your proper reimbursement.RETROSPECTIVE AUDITS – Insurance payors implement various tactics to underpay your medical claims. Payors understand that few organizations have the staff, time, or information systems required to routinely check whether the information submitted with the payment matches what the patient presented at the time of service. AMHA retrospectively reviews data that has been previously reviewed or deemed ineligible and closed. By refining the recovery process we are successful in collecting erroneous discounts that were oversights.

Our niche includes understanding "internal payor logic" within the insurance industry, and applying a strategy known as Insurance Compliance Management (ICM). By this model we help payors comply with federal and state guidelines while adjusting your proper reimbursement.Our methodology and staff philosophy deliver acute care to an otherwise chronic condition—recovering insurance dollars your organization is rightfully owed. Our program is seamless, easily implemented, and causes no disruption to your staff's daily workflow routine. IMHA commits the most capable communication skills, technology, and procedures to boost your organization's cash flow. The final analysis is more money for your organization. We will recover years of unclaimed money from contracting and non-contracting payors, MCO networks and TPAs.

AudX-MD's area of expertise is in insurance billing for Physician Assistants (PAs). PAs are typically underpaid by insurance groups which utilize various tactics such as applying Silent PPO discounts and/or bundling codes to dramatically reduce payments or deny the services. AudX-MD has helped transform the financial bottom-line for orthopedic practices which outsource their surgical PA billing to us. After implementing our program we have been able to see the PA reimbursements consistently increase from 30% to 70% of billed charges on surgeries. As a result, practices have additional income to help further grow their business.

Co-founded and managed a medical billing and auditing business that specializes in medical tourism. Managed several large customer accounts and other smaller miscellaneous accounts with an average monthly claim inventory of approximately 200-300 claims. Increased revenue from $1.1MM in collections to $1.5MM, a 26% increase. Followed up with the insurance payors on a weekly basis for updates on submitted insurance claims to verify payment status or whether additional information was required. Earned substantial continual business from clients through achieving successful reimbursements for patients which afforded them the opportunity to return for additional treatment. Marketed firm's services to hospitals' medical directors and office managers so they can relay to their patients the potential of recovering monies spent for their treatment. Marketing efforts included emails to potential clients followed up by direct contact via phone and distributed sales packets. Traveled to hospitals worldwide including Germany, Switzerland, and Bahamas to develop strong business relationships with CEOs, physicians, and facility directors.